团体怀旧疗法对老年痴呆患者影响的Meta分析

目的评价团体怀旧疗法对老年痴呆患者的干预效果。方法计算机检索万方、中国知网、PubMed、Medline、WOS合集、Cochrane library数据库,检索时限均为建库至2016年9月,并追溯纳入研究的参考文献,收集国内外应用团体怀旧疗法治疗老年痴呆患者的随机对照试验研究,并采用RevMan 5.3软件进行Meta分析。结果纳入文献13篇。Meta分析结果显示,团体怀旧疗法可改善老年痴呆患者的认知能力和抑郁情绪(P0.001),减轻其照顾者负担(P=0.002),提高生活质量(P=0.003)和一般心理健康状况(P=0.007)。结论团体怀旧疗法可用于改善老年痴呆患者的认知功能和抑郁情绪,减轻照顾者负担,进一步提高患者的生活质量和一般健康状况。     

Promise and problems in reminiscence research

Nurses use reminiscence as an intervention with elderly clients to meet a wide variety of needs. Research on reminiscence has provided some support for benefits of reminiscence in maintaining or improving mood, cognitive functioning, life satisfaction, and self-esteem in the elderly. Weaknesses in reminiscence research have been presented along with suggestions for developing a body of knowledge for nursing regarding reminiscence.     

The Effect of Reminiscence Group Work on Life Satisfaction,Self‐Esteem and Mood of Ageing People with Intellectual Disabilities

Background This study evaluates the effects of reminiscence group work on the subjective well‐being of ageing people with intellectual disabilities. Methods The content of the successive group work sessions was manipulated as follows: a control‐phase with three ‘current topics’ sessions, an experimental phase with six ‘reminiscence’ sessions and finally three ‘current topics’ sessions. Life satisfaction, perceived self‐competence and mood were measured by questionnaires, filled in by the participants and direct support workers. Results A quasi‐experimental pre‐test–post‐test design (n = 41) did not detect any changes in life satisfaction and perceived self‐competence. For mood, a quasi‐experimental ABA‐design (n = 41) did not yield an experimental treatment effect, but a significant increase in scores was observed over time. Personality characteristics ‘extraversion’ and ‘emotional stability’, but not memory specificity were found to be significant covariates for the mood scores. Conclusion Although the study’s design did not allow us to confirm the effect of reminiscence group work, the analysis nonetheless revealed some useful indications for further research. Also, interviews conducted before and after the programme resulted in positive appraisals of the programme as a worthwhile and meaningful activity for ageing people with intellectual disability.     

The effect of reminiscence music therapy sessions on changes in depressive symptoms in elderly persons with dementia

This study examined the effectiveness of reminiscence focused music therapy treatment on depressive symptoms in elderly people with dementia. Twenty elderly (3 male & 17 female) who were diagnosed as having dementia and residing at 2 different residential care facilities in Florida were assigned to 1 of 4 small groups. Each of the participants served as his or her own control in an O1 O2 X O3 design. The depressive symptoms were measured using Cornell Scale for Depression in Dementia. The differences between the scores of pretest, posttest 1 after a week of 5-day no treatment, and posttest 2 after a week of 5-day reminiscence focused music therapy treatment were compared. A one-way analysis of variance (ANOVA) and Newman-Keuls Multiple Comparison Procedure indicated statistically significant differences between pretest and posttest 2 as well as posttest 1 and posttest 2, while no significant differences were found between pretest and posttest 1. Results indicated that participation in small group reminiscence focused music therapy groups might help to reduce depressive symptoms in elderly people with dementia. Results of behavioral observations and future implications are also discussed.     

Efficacy of a Peer‐Guided Exercise Programme for Adolescents with Intellectual Disability

Background Peer support is strongly associated with physical activity of adolescents. This study examined the efficacy of a YMCA‐based, peer‐guided exercise training programme for increasing health‐related physical fitness among adolescents with intellectual disabilities. Materials and Methods Adolescents with intellectual disabilities and typically developing peer partners provided reciprocal support during 1‐h exercise sessions that included aerobic exercise, weight training and stretching activities. The programme was conducted 2 days/week for 15 weeks and pre‐ and post‐test fitness testing was conducted. Results Participants demonstrated significant improvements in curl‐ups, 6‐min walk and BMI. Exercise session attendance was high and participants typically completed all of the prescribed aerobic and stretching exercises, whereas weight training exercises were completed less consistently. Conclusions This peer‐guided model integrates social and instructional support for adolescents with intellectual disabilities and may encourage exercise participation in community settings.     

Effectiveness of reminiscence therapy in reducing agitation and depression and improving quality of life and cognition in long-term care residents with dementia: A systematic review and meta-analysis

This paper assesses the effectiveness of reminiscence therapy (RT) in people with mild to moderate dementia in long-term care facilities. A literature search was conducted in CINAHL, MEDLINE, PsychINFO, and Embase from inception to December 2020. Five RCTs with 267 participants were included; two were meta-analysed. Cochrane collaboration's risk of bias tool was used to evaluate the methodological quality of the included RCTs, and the risk of bias across studies was assessed using the GRADE method. The overall quality of evidence was moderate to low. Among the five trials, none measured the efficacy of RT on agitation. Reminiscence therapy was effective in reducing depression and improving autobiographical memory, but its effects were inconsistent. There was a significant improvement in quality of life (QoL) following RT. The meta-analysis showed no statistical significance on the pre-post intervention differences in depression (SMD -0.28, 95%CI -0.91–0.35, p > 0.05) and autobiographical memory scores (SMD 0.57, 95%CI -0.07–1.21, p > 0.05). Reminiscence therapy may have some benefits in reducing depression and improving the QoL and cognition in this population; however, its effectiveness should be tested further.     

Reminiscence therapy for older adults with Alzheimer's disease: A literature review

The literature on the use of reminiscence therapy is vast in patients with dementia, but there is minimal evidence in older adults with Alzheimer's disease. The current review seeks to develop a unifying way to administer reminiscence therapy that will be effective for older adults with Alzheimer's disease. The review used the PRISMA guidelines in the literature search and data extraction. Results showed the effectiveness of reminiscence therapy in older adults with Alzheimer's disease, area of cognition, depression, activities of daily living, and quality of life. Additionally, for the therapy to be effective, it must be conducted regularly in a small group of patients for an average of 45 min for 8‐ to 12‐week duration. Patients with mild‐to‐moderate Alzheimer's disease are most likely to benefit with the use of photographs, videos, and music that are associated with their past experiences. This review highlights innovative ways to render reminiscence therapy to individuals with Alzheimer's disease including technology‐aided applications.     

A therapeutic programme for people with dementia

Gibb H, Morris CT, Gleisberg J. International Journal of Nursing Practice 1997; 3 : 191–199
A therapeutic programme for people with dementia
A programme involving Tai Chi and structured reminiscence was trialed with nine people suffering from moderately advanced dementia. The analysis reported here aimed to examine stories the people told with a view to understanding the purpose of story telling in their lives. Themes derived from the narrative data had a strong evaluative quality, ranging from simple evocative expressions to more cognitive complex insights or treasures. The study indicated a major aim in story telling as being able to generate life values, both for the enrichment of identification of self, and to pass on or leave for today's youth. Findings here further substantiate Luke and Freiden's view that old age has its own cognitive and spiritual goals to achieve. There is strong evidence that people with moderate dementia still aim to participate in that endeavour.     

Interventions to reduce vasovagal reactions in blood donors: a systematic review and meta‐analysis

Vasovagal reactions (VVRs) in blood donors have significant implications for the welfare of donors, donor retention and the management of donor sessions. We present a systematic review of interventions designed to prevent or reduce VVRs in blood donors. Electronic databases were searched for eligible randomised trials to March 2015. Data on study design and outcomes were extracted and pooled using random effects meta‐analyses. Sixteen trials met the inclusion criteria: five trials (12 042 participants) of pre‐donation water, eight trials (3500 participants) of applied muscle tension (AMT) and one trial each of AMT combined with water, caffeine, audio‐visual distraction and/or social support. In donors receiving pre‐donation water, the relative risk (RR) compared with controls for VVRs was 0·79 [95% confidence interval (CI) 0·70–0·89, P < 0·0001] and the mean difference (MD) in severity of VVRs measured with the Blood Donation Reactions Inventory (BDRI) score was ?0·32 (95% CI ?0·51 to ?0·12, P < 0·0001). Excluding trials with a high risk of selection bias, the RR for VVRs was 0·70 (95% CI 0·45–1·11, P = 0·13). In donors who received AMT, there was no difference in the risk of chair recline in response to donor distress from controls (RR 0·76, 95% CI 0·53–1·10, P = 0·15), although the MD in BDRI score was ?0·07 (95% CI ?0·11 to ?0·03, P = 0·0005). There was insufficient data to perform meta‐analysis for other interventions. Current evidence on interventions to prevent or reduce VVRs in blood donors is indeed limited and does not provide strong support for the administration of pre‐donation water or AMT during donation. Further large trials are required to reliably evaluate the effect of these and other interventions in the prevention of VVRs.     

Art in Alzheimer's Care: Promoting Well‐Being in People with Late‐Stage Alzheimer's Disease

The purpose of this qualitative study was to explore the responses of people with late‐stage Alzheimer's disease (AD) to a creative bonding intervention (CBI). The CBI consisted of simple art activities. Guided by Reed's self‐transcendence theory, research questions were “Will persons with late‐stage AD show evidence of self‐transcendence during the CBI?” and “Will persons with late‐stage AD show evidence of well‐being during the CBI?” Twelve CBI sessions, documented by videotape and field notes, were conducted with four participants. Themes emerged within two clusters: trusting/thirsting/following and choosing/connecting/reminiscing. An overarching category of “cocooning” described participants' world during the CBI as they displayed evidence of self‐transcendence and well‐being. The CBI is a strategy that can be implemented by staff, families, and volunteers. Nurses are positioned to provide transformation leadership for implementation of creative approaches during care of people with late‐stage AD, but administrative and financial support are needed.